How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $37.15 | Professional | None | $36.31 | $36.31 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Professional Modifier RR · Rental Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | RR · Rental | $109.65 | $109.65 | $109.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $177.83 | Professional | None | $107.15 | $134.90 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $36.31 Median $61.66 Typical High $81.28 | Facility | None | $36.31 | $61.66 | $81.28 |
Moda Health Setting Professional Modifier None Typical Low $36.31 Median $66.07 Typical High $77.62 | Professional | None | $36.31 | $66.07 | $77.62 |
Pacific Source Setting Facility Modifier None Typical Low $67.61 Median $74.13 Typical High $79.43 | Facility | None | $67.61 | $74.13 | $79.43 |
Pacific Source Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $69.18 | Professional | None | $67.61 | $69.18 | $69.18 |
Providence Setting Facility Modifier None Typical Low $44.67 Median $50.12 Typical High $75.86 | Facility | None | $44.67 | $50.12 | $75.86 |
Providence Setting Professional Modifier None Typical Low $38.02 Median $52.48 Typical High $79.43 | Professional | None | $38.02 | $52.48 | $79.43 |
Providence Setting Professional Modifier RR · Rental Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | RR · Rental | $109.65 | $109.65 | $109.65 |
Regence BlueShield Setting Facility Modifier None Typical Low $53.70 Median $109.65 Typical High $257.04 | Facility | None | $53.70 | $109.65 | $257.04 |
Regence BlueShield Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $83.18 | Professional | None | $75.86 | $79.43 | $83.18 |
United Setting Professional Modifier None Typical Low $25.70 Median $32.36 Typical High $64.57 | Professional | None | $25.70 | $32.36 | $64.57 |
3 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.62 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.98 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.47 | $3.98 | $7.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Where Oregon sits
The same service costs 2.5 times more in Wyoming than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oregon· 12th of 51
$64.57
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.